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Association between the Use of Diuretics and Size Reduction in Pediatric Atrial Septal Defect

Jue Seong Lee1,2, Gi Beom Kim3, Won Jung Lee4

  • 1Department of Pediatrics, Korea University College of Medicine and Korea University Medical Center, Seoul, Korea.

Korean Circulation Journal
|October 1, 2021
PubMed

Insights

Diuretics may help reduce atrial septal defect (ASD) size in pediatric patients, potentially decreasing the need for surgical intervention. This study found diuretic use associated with ASD size reduction over time.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Medical Interventions

Background:

  • Atrial septal defect (ASD) is a common congenital heart condition.
  • The role of diuretics in managing ASD size remains incompletely understood.
  • Current treatment strategies for ASD vary, with surgical or device closure being common.

Purpose of the Study:

  • To investigate the efficacy of diuretic administration in reducing the size of atrial septal defects in children.
  • To determine if diuretic use impacts the need for surgical or device closure of ASDs.

Main Methods:

  • Retrospective analysis of medical records for pediatric patients with secundum ASD (≥10 mm) diagnosed between 2005 and 2019.
  • Patients were categorized into two groups: those who received diuretics and those who did not.
  • Statistical analysis, including linear mixed-effects modeling, was used to assess changes in ASD diameter over time.

Main Results:

  • Diuretic use was significantly associated with a reduction in both ASD diameter and indexed ASD diameter over the follow-up period.
  • The non-diuretic group showed a significant increase in ASD diameter, while the diuretic group experienced a decrease.
  • Device closure was performed more frequently in patients who received diuretics (75.0%) compared to those who did not (39.4%).

Conclusions:

  • Diuretic administration in pediatric patients with ASD appears to be linked to a decrease in defect size.
  • This size reduction may lead to a lower likelihood of requiring surgical intervention for ASD closure.
  • Diuretics might facilitate the use of smaller devices for transcatheter closure of ASDs.
Abstract

Keywords:
Atrial septal defectDeviceDiureticsPediatricsSurgery

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